Arda Kiani - Academia.edu (original) (raw)

Papers by Arda Kiani

Oman Medical Journal, 2020

ndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a modality with re... more ndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a modality with remarkable diagnostic yield and is less invasive than video-assisted thoracoscopic surgery or transthoracic needle aspiration. 1,2 During the last decade, EBUS-TBNA has attained widespread acceptance as a minimally invasive and accurate technique for investigating mediastinal lymph nodes (LNs) to diagnose both non-malignant and malignant diseases. 3 In cases with suspected malignancy, EBUS has been used for diagnosing and staging in patients with lung cancer. 2,4-8 Real-time visualization of the LNs during sampling provides useful information about its structural and morphological characteristics. 9 There is increasing interest in the sonographic features of the mediastinal LNs, which are consistent with pathology original article

Advances in Respiratory Medicine

Thrombosis is an important pathology in the deterioration of COVID-19 patient [...]

Vaccine Research

Recently the term vaccine-induced immune thrombotic thrombocytopenia (VITT) used for individual w... more Recently the term vaccine-induced immune thrombotic thrombocytopenia (VITT) used for individual which have thrombotic phenomena followed by ChAdOx1 nCoV-19 vaccine (AstraZeneca) administration against SARS coronavirus. Here we report the 27 years old healthy male and known case of G6PD deficiency which come to emergency department with progressive right calf swallow from 12 days ago and hemoptysis from a day ago. he mentioned he had administrated First dose of AstraZeneca vaccine for 3 weeks ago. He admitted with suspected pulmonary thromboembolism (PTE) followed by Deep vein thrombosis (DVT). In color Doppler study there are dilation in right calf vain with elevated lab measurement d-dimer indicated DVT also in computed tomography angiography (CTA) there are some evidence of filling defect in left pulmonary branch and right inferior lobar artery which represent to PTE.

Current Respiratory Medicine Reviews, 2022

Background: Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant imbala... more Background: Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant imbalance and systemic inflammation. Objective: This study was conducted to evaluate associations of serum levels of C-reactive protein (CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD. Methods: A matched case-control study was performed among 200 COPD patients (100 cases and 100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators with equal to or greater than two ambulatory exacerbations or one hospitalization; controls were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months. Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis. In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research Council (mMRC) dyspnea scale, and the BODEx index were applied. Results: The mean (SD) age of the patients was 65.31 (8.46) year...

HIV & AIDS Review, 2020

Introduction: Respiratory diseases, including infectious and non-infectious complications are com... more Introduction: Respiratory diseases, including infectious and non-infectious complications are common among patients with human immunodeficiency virus (HIV) infection. We aimed to determine the performance of fiberoptic bronchoscopy (FOB), bronchoalveolar lavage, and transbronchial lung biopsy in HIV-infected patients. Material and methods: The current retrospective study was performed in Masih Daneshvari Hospital, Tehran, Iran, from January 2003 to March 2017. Patients with HIV infection and 836 episodes of respiratory manifestations were selected. Indications, outcomes as well as results and complications of bronchoscopy were extracted. Performance of bronchoscopy to determine definite etiology and its ability to rule out other differential diagnoses were evaluated. Results: The indications of FOB were found in 289 subjects (34.6%) with respiratory diseases, of whom only 220 patients had undergone the procedure. Bronchoscopy confirming a final diagnosis was found in 87 (39.5%) patients and a diagnostic benefit was noted for minimum 66.7% of the subjects. Diagnostic ability of bronchoscopy was higher in patients suspected of pneumocystis jiroveci pneumonia (PJP), tuberculosis (TB), cytomegalovirus (CMV) pneumonitis, and in cases with ground-glass opacity and diffuse lung infiltrates (p-value: 0.003 and 0.035, respectively), and lower for subjects demonstrating reticulonodular infiltrations and right middle and lower lobes involvement (p-value: 0.008, 0.005, and 0.045, respectively). Procedure-related complications were reported in five subjects. Conclusions: FOB is a significantly advantageous and safe procedure in HIV-infected patients. Its diagnostic yield is higher in patients with ground-glass opacity and diffuse infiltration in chest computed tomography scan.

Polish Journal of Radiology, 2021

Purpose: Eosinophilic lung diseases are a group of pulmonary disorders associated with peripheral... more Purpose: Eosinophilic lung diseases are a group of pulmonary disorders associated with peripheral or tissue eosinophilia. They can be classified into primary (idiopathic) and secondary groups based on their aetiology. On the other hand, blood eosinophilia is a common clinical problem with various causes. In many cases the lung infiltrations in patients with peripheral eosinophilia are non-eosinophilic. Herein, we aim to assess the relationship between blood eosinophilia and abnormal high-resolution computed tomography (HRCT) features and their extent in idiopathic chronic eosinophilic pneumonia (ICEP) (the most common form of idiopathic eosinophilic lung disease). This can help in differentiating eosinophilic from non-eosinophilic lung infiltrations in patients with blood eosinophilia. Material and methods: In this descriptive-correlational study, all patients with proven ICEP, who were referred to Masih Daneshvari Hospital, Tehran, Iran from 2012 to 2019, were included. The ICEP diagnosis was based on lung infiltrations on imaging, in addition to increased numbers of eosinophils in bronchoalveolar lavage fluid, blood or lung biopsy samples, and rapid response to corticosteroids. Patients with known aetiologies for eosinophilic lung diseases were excluded. The HRCT findings and their extent in each patient were compared with the blood eosinophil level. Results: Positive correlation was found only between blood eosinophil level and frequency and extent of consolidation, and with frequency of lymphadenopathy. Conclusions: HRCT can help to differentiate eosinophilic from non-eosinophilic lung infiltrations in patients with blood eosinophilia by comparing the extent of consolidation with the blood eosinophil level.

Airway pharmacology and treatment, 2020

Malignant Pleural Effusion (MPE) occurs in most patients with advanced cancer [1] and accounts fo... more Malignant Pleural Effusion (MPE) occurs in most patients with advanced cancer [1] and accounts for 15 to 35 percent of all pleural effusions [2]. Most MPEs are caused by metastases, especially in lung cancer, in more than one-third of cases and in breast cancer in the latter stages [3]. Variety of symptoms such as progressive dyspnea, cough and chest pain reduces the quality of the short-lived survival of these patients [4] and in some cases can be fatal and therefore, it is associated with poor prognosis and significant mortality and morbidity [1]. Despite all treatments such as surgery, chemotherapy and radiotherapy, survival rates in primary pulmonary cancer patient with MPE are low [5]. This effusion usually does not respond to systemic chemotherapy and treatment is mostly symptomatic [6]. In many patients, tubal drainage and pleurodesis are used to control plural effusion by injecting sclerosing agents, but the failure to respond to pleurodesis require frequent necessity for dr...

Tanaffos, 2020

Mitra Safa , Arda Kiani, Fatemeh Razavi , Fatemeh Ghassem Boroujerdi , Farzaneh Haji Zadeh 3 , Ba... more Mitra Safa , Arda Kiani, Fatemeh Razavi , Fatemeh Ghassem Boroujerdi , Farzaneh Haji Zadeh 3 , Bamdad Mirab Zadeh , Atefeh Abedini 3 1 Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran, 2 Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 3 Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Purpose: Tracheobronchopathia Osteochondroplastica is a rare benign disease characterized by calc... more Purpose: Tracheobronchopathia Osteochondroplastica is a rare benign disease characterized by calcified sub mucosal nodules in large airways. Treatment is usually palliative with more options (laser ablation or surgical treatment) in severe symptomatic cases. No definitive treatment for this disease has been introduced yet. In current study we report a new technique of endobronchial pneumatic lithotripsy in a symptomatic case of Tracheobronchopathia Osteochondroplastica Method: Patient was a 28-year-old woman presented with dyspnea to the referral center for pulmonary diseases in Tehran, Iran. She underwent bronchoscopy during which submucosal obstructing nodules were recognized. Pathologic evaluation of biopsies was compatible with diagnosis of Tracheobronchopathia Osteochondroplastica. As patient was reluctant to undergo surgical treatments or laser therapy, we suggested a novel procedure of applying pneumatic lithotripsy device through rigid bronchoscope in order to fragment the o...

Acta Bio Medica : Atenei Parmensis, 2020

Background The sudden outbreak of the COVID-19 disease originated in Wuhan, China, in December 20... more Background The sudden outbreak of the COVID-19 disease originated in Wuhan, China, in December 2019. There have been few reports on the clinical course of the disease, but detailed information on the risk factors for increased hospital stay and mortality is not available. In this study we aimed to present the details of 53 confirmed COVID-19 cases to share the clinical course and the risk factors for longer hospital stay and death. Methods In this study, we enrolled fifty-three patients with confirmed COVID-19 infection from a referral academic hospital in Tehran, Iran admitted between March and April 2020. Patients’ demographics, laboratory tests, treatments, length of hospital stay (LOHS), and final outcome were recorded and analyzed. Results Fifty-three patients were included in this study. The higher LOHS was associated with clinical symptoms, including hemoptysis (IRR= 0.73, P-value= 0.02), diarrhea (IRR= 0.78, P-value= 0.01), headache (IRR= 0.81, P-value= 0.05), and dry cough ...

Pneumologia, 2016

Pleuroscopy is a safe diagnostic procedure for evaluation of pleural diseases, with minimum compl... more Pleuroscopy is a safe diagnostic procedure for evaluation of pleural diseases, with minimum complications. This procedure has been recently conducted on outpatient basis. Results support its safety, especially in busy referral hospitals. We aimed to report our experience on performing outpatient pleuroscopy at Masih Daneshvari hospital; Tehran, Iran. All eligible patients referred to Masih Daneshvari Hospital for pleuroscopy between May 2015 and May 2016 were enrolled. Air evacuation was conducted in operating room though a thin Nelaton catheter attached to low pressure suction. Compression dressing using Vaseline gauze was done after air leak terminated. Patients were discharged if first chest x-ray was negative for pneumothorax and were advised to stay in touch and return 12 hours later for second chest radiograph. Baseline characteristics, radiographic and pathologic reports were reviewed. Outpatient pleuroscopy was conducted on 10 patients. Average procedure time was 22±9 minute...

International Immunopharmacology, 2020

Background: The clinical presentation of SARS-CoV-2 infection ranges from mild symptoms to severe... more Background: The clinical presentation of SARS-CoV-2 infection ranges from mild symptoms to severe complications, including acute respiratory distress syndrome. In this syndrome, inflammatory cytokines are released after activation of the inflammatory cascade, with the predominant role of interleukin (IL)-6. The aim of this study was to evaluate the effects of tocilizumab, as an IL-6 antagonist, in patients with severe or critical SARS-CoV-2 infection. Methods: In this prospective clinical trial, 76 patients with severe or critical SARS-CoV-2 infection were evaluated for eligibility, and ultimately, 42 patients were included. Tocilizumab was administered at a dose of 400 mg as a single dose via intravenous infusion. Primary outcomes included changes in oxygenation support, need for invasive mechanical ventilation, and death. Secondary outcomes included radiological changes in the lungs, IL-6 plasma levels, C-reactive protein levels, and adverse drug reactions. The data were analyzed using SPSS software. Results: Of the 42 included patients, 20 (48%) patients presented the severe infection stage and 22 (52%) were in the critical stage. The median age of patients was 56 years, and the median IL-6 level was 28.55 pg/mL. After tocilizumab administration, only 6 patients (14%) required invasive ventilation. Additionally, 35 patients (83.33%) showed clinical improvement. By day 28, a total of 7 patients died (6 patients in the critical stage and 1 patient in the severe stage). Neurological adverse effects were observed in 3 patients. Conclusions: Based on the current results, tocilizumab may be a promising agent for patients with severe or critical SARS-CoV-2 infection, if promptly initiated during the severe stage.

Iranian Journal of Allergy, Asthma and Immunology, 2020

This article is a Letter to the Editor and does not include an .

Generation of medical assisting tools using recent artificial intelligence advances is beneficial... more Generation of medical assisting tools using recent artificial intelligence advances is beneficial for the medical workers in the global fight against COVID-19 outbreak. In this article we introduceai-corona, a radiologist-assistant deep learning framework for COVID-19 infection diagnosis using the chest CT scans. Our framework incorporates an Efficient NetB3-based feature extractor. We employed three independent dataset in this work named: CC-CCII, MDH, and MosMedData; all includes 7184 scans from 5693 subjects which contained pneumonia, common pneumonia (CP), non-pneumonia, normal and COVID-19 classes. We evaluatedai-coronaon test sets from the CC-CCII set and MDH cohort and the entirety of the MosMedData cohort, for which it gained AUC score of 0.997, 0.989, and 0.954, respectively. We further compared our framework’s performance with other deep learning models developed on our employed data sets, as well as RT-PCR. Our results show thatai-coronaoutperforms all. Lastly, our framew...

Journal of Minimally Invasive Surgical Sciences, 2018

Introduction: Foreign body aspiration into the respiratory tract is a life-threatening condition ... more Introduction: Foreign body aspiration into the respiratory tract is a life-threatening condition and an important cause of morbidity and mortality due to the suffocation in the pediatric age. Case Presentation: We present a foreign body aspiration which is related to a seven-year-old Iranian boy. His complaints included an intermittent cough and dyspnea. The distal impacted endobronchial foreign body has been retrieved by using rat tooth forceps under C-arm-guided flexible bronchoscopy after the failure of two previous interventions. Conclusions: In order to reduce the unsuccessful efforts and also mortality and morbidity rate which are the result of foreign body aspiration, early recognition and also appropriate intervention are crucial. For this purpose, the use of the fluoroscope C-arm device before bronchoscopy may increase the chance of successful extraction of an endobronchial foreign body.

Sarcoidosis and other granulomatous ILD/DPLD, 2019

Introduction: Sarcoidosis is a granulomatous disease, and about 1-15% of patients with sarcoidosi... more Introduction: Sarcoidosis is a granulomatous disease, and about 1-15% of patients with sarcoidosis show sinonasal involvements. Since, sinonasal involvements are similar to non-sarcoid rhinosinusitis and infectious rhinosinusitis and allergies, accurate diagnosis of Sinonasal Sarcoidosis (SNS) patients is mandatory to minimize unnecessary antibiotics and surgical treatments in sarcoidosis patients. This was the first study in Iran, to evaluate the SNS cases and their clinical presentations. Methods: In this cross-sectional study, eighty-eight biopsy proven sarcoidosis patients, with head and neck complaints, were included. All patients underwent the Computed Tomography of Para-nasal Sinuses (CT PNS) and a biopsy sampling through the rhinoscopy. Data were analyzed by Statistical Package for Social Sciences (SPSS) and differences between two groups were obtained with consideration of p-value of Results: CT PNS confirmed sinonasal disorders in 32 patients. 18 of 32 SNS patients had pulmonary involvements (56.25%). Rhinoscopy demonstrated nasal crusting in four patients (14.3%), septal perforation in three patients (8.6%), mucosal hypertrophy in nine patients (28.6%), synechia in two patients (5.7%), middle turbinate hypertrophy in four patients (11.4%) and submucosal nodule in ten patients (31.4%). Conclusions: Sinonasal involvement in patients with sarcoidosis may not be correctly detected only based on the symptoms. Hence, we suggest CT scan as the first diagnostic step in patients suspected to sinonasal involvements. In the case of observing an abnormal CT pattern and an increase in the level of ACE, further histopathologic examinations on the sinonasal biopsies is recommended.

Sarcoidosis and other granulomatous ILD/DPLD, 2018

Background The 6-minute walking test, cardiopulmonary exercise testing, and spirometry are useful... more Background The 6-minute walking test, cardiopulmonary exercise testing, and spirometry are useful tools for evaluation of respiratory impairment and functional capacity in patients with lung disease. Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Objectives Since the pulmonary involvement can affect the quality of life in sarcoidosis patients, this study is aimed to evaluate the tests mentioned above in order to examine the functional capacity of sarcoidosis patients in different stages as well as the cause of exercise intolerance. Methods This cross-sectional study was carried out on 50 Iranian patients with sarcoidosis. Patients were classified into three groups based on the findings of the chest radiography as well as the pulmonary CT scan, reported by an expert radiologist. Pulmonary, cardiac, and activity function have been evaluated in the patients, using cardiopulmonary exercise testing, the 6-minutes walking test, and spirometry. Results In cardiopulmonary exercise testing, percent-predicted peak VO2 (57.75±15.49, p=0.015) and percent-predicted O2 pulse (70.54±17.37, p=0.013) were significantly lower in the third group, in comparison with the others. Also, VE/CO2 (AT) (34.99±5.67, p=0.000) was significantly higher in the third group, in comparison with the other ones. Percent-predicted VO2 showed a strong positive correlation with age (r=0.377, p=0.009), TSH (r= 0.404, p=0.007), and percent-predicted FVC (r=0.443, p=0.002). In addition, O2 pulse had a positive correlation with BMI (r=0.324, p=0.026), percent-predicted FVC (r=0.557, p= 0.000), and percent-predicted FEV1 (r=0.316, p=0.032). Conclusions According to this study, ventilatory limitation, pulmonary involvement, and deconditioning are the main causes of activity limitations in sarcoidosis patients.